Factors influencing degree of hearing loss at presentation, hearing aid choice, and usage in first time hearing aid users in Singapore

<p><b>Objective:</b> To examine the factors associated with late presentation at first hearing aid (HA) fitting, HA choice and usage among users in Singapore.</p> <p><b>Design:</b> Retrospective cross-sectional study.</p> <p><b>Study sample</b>: 1068 subjects issued with HAs at a tertiary hospital from 2001 to 2013.</p> <p><b>Results:</b> Half of the subjects presented with more severe (>55 dB) hearing loss (HL) in their better ear. In multivariable analysis, older age, Malay ethnicity, conductive and mixed HL, and combination type of HL were associated with more severe HL at first presentation. Over 70% of subjects were older than 65 years. Worse pure tone audiometry (PTA) thresholds of the better ear, gradual onset and sensorineural HL were associated with older age presentation. For unilaterally fitted subjects, PTA thresholds were the only determinant of having the better ear aided. Better PTA thresholds, younger age and sensorineural HL were associated with choosing in ear compared to behind the ear HAs. Younger age and worse PTA of the better ear were associated with ≥4 h of daily HA usage.</p> <p><b>Conclusions:</b> Age, ethnicity and type of HL were important determinants for more severe HL at first HA fitting. Older patients and those with better hearing were less likely to use their HAs regularly.